This article is more than 5 years old. Information may no longer be current.
Diabetes has many faces in the eye care practice
Hardly a day goes by when we don’t think about it. A 15-year-old type 1 diabetic presents for an annual dilated fundus examination. A 40-year-old adult develops a sudden refractive error shift consistent with incipient diabetes. A 60-year-old longstanding type 2 diabetic returns for a cataract evaluation. Indeed, our patients remind us of the many faces of diabetes on a daily basis.
As eye care providers we are – for the most part — fairly well equipped to deal with the many manifestations of diabetes. We understand its pathophysiology and disease progression. We’re adept at diagnosing and monitoring diabetic eye disease. And we understand how to manage our patient’s ocular and visual needs. Indeed, it seems as though we have our finger on the pulse of diabetes. But do we really understand the magnitude of the disorder?
Diabetes on the rise
The Centers for Disease Control and Prevention (CDC) estimates that more than 16 million adults in America suffer from diabetes. The National Eye Institute (NEI) reports that approximately 45% of these individuals manifest some degree of diabetic eye disease, with background diabetic retinopathy as the most common presentation. Furthermore, the NEI estimates that more than 20,000 Americans are blinded by diabetes annually.
If these numbers aren’t staggering enough, diabetes is on the rise. In the September issue of Diabetes Care, researchers from the CDC reported that diabetes among adults increased rapidly during the 1990s. The trend spared no age group, as new cases of diabetes rose 70% among 30- to 39-year-olds and 40% among those in their 40s.
Likewise, the disease crossed all ethnic boundaries with a 38% increase among Hispanics, a 29% increase in whites and a 26% increase in blacks. Finally, diabetes appears to impact all socioeconomic strata with a 47% increase noted among college graduates.
Increased awareness, earlier diagnosis
Undoubtedly, it will take us some time to sort out the numbers. Certainly, part of the increase is a testimony to improved health care – increased public awareness and earlier diagnosis. Unfortunately, a portion of the increase is attributable to lifestyle – poor dietary choices, sedentary tendencies and obesity. Perhaps the most disturbing aspect of diabetes is the sheer number of undiagnosed cases.
As eye care providers it’s essential that we vigilantly care for our existing diabetic patients. It’s equally important that we identify those with undiagnosed diabetes, as early intervention can have a profound impact on morbidity and mortality.
So as we contemplate the CDC’s estimated 800,000 new cases of diabetes that will be diagnosed in the United States next year, we should ask ourselves one question: How many of those individuals are my patients?